Cerebral palsy is the name for a group of related conditions that affect a child's brain, and come with a range of physical symptoms from movement difficulties to challenges with communication. When cerebral palsy is caused by mistakes that were made immediately before, during or after childbirth, it may be the result of medical negligence.

Not every case of cerebral palsy results from medical negligence, but when avoidable failures were made in maternity or neonatal care, families can often make a cerebral palsy compensation claim. Because this distinction is important, solicitors specialising in cerebral palsy claims need to secure strong evidence that shows the role of clinical negligence in the child's brain injuries.

The legal specialists in JMW's clinical negligence department are experts in cerebral palsy cases, and have a proven track record of success in claims for the children and families affected. In this blog, we explain the evidence we need to investigate medical negligence, how we work with experts to assess the cause of a child's injuries and the impact on their life, and what families can expect from the legal process if they decide to pursue compensation.

What are the key elements to prove in a cerebral palsy medical negligence claim?

A medical negligence claim involves establishing that the care provided to a patient fell below a reasonable standard and caused them avoidable harm. There are four key elements that must be proved to establish the person's legal right to claim and deliver the compensation they are owed.

1. A duty of care: The doctor, midwife, nurse or hospital had a responsibility to provide appropriate medical treatment. This applies automatically when cerebral palsy has arisen during childbirth, as medical staff always have a duty of care to patients, including both the child and their mother.
2. Breach of duty: The care provided fell below the standard expected of a reasonably competent healthcare professional. We often work with experienced, independent medical experts to assess the care provided to you and your baby and identify any areas where it fell below the necessary standards.
3. Causation: The failures in care caused or materially contributed to the child's injury. This is not always straightforward to demonstrate, as establishing causation means showing that the child's brain injury would probably have been avoided, or its consequences reduced, if appropriate care had been provided. Where the baby's brain was affected by a head injury caused by misuse of forceps, this may be straightforward to prove, whereas it can be more difficult if the underlying reason that the child developed cerebral palsy is not clear.
4. Harm and loss: The child experienced avoidable injury and its associated consequences. A diagnosis of cerebral palsy and the financial losses that often come with caring for a child with additional needs are usually enough to establish this aspect of the claim.

To build a strong case, JMW gathers a range of evidence. This is not only designed to prove that medical negligence occurred; evidence is also needed to provide suitable compensation for all  the relevant costs involved in the child's future, caused by the negligence.

Read our guide on how to prove medical negligence.

Which medical records are needed to prove cerebral palsy negligence?

Medical records are central to cerebral palsy compensation claims because they establish what happened during pregnancy, labour, delivery and the period immediately after birth. Parents' accounts and witness statements also provide additional evidence about the birth, whether concerns were raised and what medical staff did or said at the time, which provides context for the actions that were taken.

Key medical evidence includes:

Pregnancy and antenatal records

Antenatal records document your baby's development and any concerns identified during pregnancy. Relevant evidence among these records includes ultrasound scans, fetal growth measurements, blood test results, appointment notes and records of referrals to specialist maternity services.

These documents help experts to assess whether doctors and midwives recognised potential complications and responded appropriately. They will also indicate any secondary problems resulting from the cerebral palsy diagnosis that may affect how much compensation the child could claim.

Labour and delivery records

Labour records are particularly important where a cerebral palsy claim involves concerns about oxygen deprivation or delays in delivery. Relevant evidence includes:

• CTG traces: Records of the baby's heart rate and uterine contractions, which can identify possible fetal distress.
• Labour notes: Details of observations, concerns, decisions and treatment.
• Delivery records: Information about any assisted delivery or emergency caesarean section that took place, and any complications.
• Medication records: Details of drugs used to induce or manage labour.
• Staff records: Information about when concerns were escalated to an obstetrician.

The aim is to often prove that opportunities to act and prevent the brain damage that led to cerebral palsy were missed, or that the wrong clinical decisions were made in the moment. For example, if an umbilical cord complication affected the baby's oxygen supply, medical records may establish whether staff recognised the danger and acted appropriately. If they did not, this may amount to negligence.

Neonatal records, MRI scans and other medical evidence

Neonatal records describe the baby's condition immediately after birth, including their breathing, heart rate, oxygen levels and any resuscitation required. Among the documents in this category, blood gas results, Apgar scores and neonatal intensive care records may provide important information about the baby's condition.

One condition experts may investigate is hypoxic ischaemic encephalopathy (HIE), which involves brain injury associated with reduced oxygen and blood supply. NICE guidance provides a thorough list of steps that medical staff should take to identify cerebral palsy and HIE, and we will work with an independent expert to evaluate these findings alongside the full medical history. This allows them to determine whether the right steps were followed, or whether medical negligence caused the injury.

How do independent medical experts establish what caused cerebral palsy?

In our cerebral palsy compensation cases, we work with independent medical experts to assess whether the care provided met reasonable standards and whether any failures caused or contributed to the child's brain injury. They will produce a report on their findings that is often a key piece of evidence for the court.

Depending on the nature of your child's injury or the factors that we believe led them to develop cerebral palsy, we may ask different specialists to examine aspects of the case.

• Obstetricians can review decisions made during pregnancy, labour and delivery.
• Midwifery experts can assess monitoring, communication and escalation of concerns.
• Neonatologists can examine the baby's condition and treatment after birth.
• Paediatric neurologists can assess neurological injury and brain imaging.

These experts also consider other possible causes of cerebral palsy, including conditions affecting the developing brain before birth, and whether clinical negligence could have played a role.

Does the type of cerebral palsy affect the evidence needed?

Different types of cerebral palsy affect movement, coordination and muscle tone in different ways. The type of cerebral palsy does not establish whether medical negligence occurred, but it may affect the amount of compensation your child receives, and therefore the types of evidence we will collect.

The NHS identifies four main types of cerebral palsy:

The type of cerebral palsy may influence which medical experts are instructed and what evidence is needed to assess the child's condition. For example, a child with quadriplegic cerebral palsy (which refers to a condition that affects all four limbs) will have different needs because their motor function may be much more limited than a child who can walk unaided. If they need additional mobility aids or movement support, this will form part of the compensation you can claim on their behalf.

What other evidence is needed to assess cerebral palsy compensation?

Cerebral palsy compensation claims also require evidence of how the avoidable injury affects a child's everyday life and their future needs. Depending on how cerebral palsy affects the child, it may cover care costs, lost earnings (if the developmental delay will affect the child's earning potential when they grow up), mobility aids and more. Evidence that we will use to calculate damages in a cerebral palsy claim includes:

• Care assessments that show how much personal assistance or supervision the child needs, and identify any lifelong care requirements.
• Therapy assessments with recommendations from physiotherapists, occupational therapists and speech and language therapists.
• Equipment and accommodation assessments if the child will need specialist equipment to account for accessibility requirements, or home adaptations to enable them to live comfortably.
• Educational assessments covering any additional learning and communication support they will need.
• Financial evidence regarding medical expenses, care costs and other losses attributable to the negligence.

Cerebral palsy compensation aims to reflect the harm caused by negligence and the associated care, support and financial needs. Depending on how the injury occurred and what the child needs for their future, it can cover muscle issues, chronic pain and any other symptoms, along with the costs of care, occupational therapy, medicine to manage pain and other related financial losses.

How JMW can help you to claim compensation

If you believe negligent care during pregnancy, labour or birth caused your child's cerebral palsy, the specialist solicitors in JMW's medical negligence team are here to listen and explain your options.

We have extensive experience and a proven track record in investigating cerebral palsy compensation claims, including cases involving delayed delivery, oxygen deprivation and avoidable brain injuries. We take on most birth injury claims on a no win, no fee basis, to limit any financial risk posed by legal expenses.

Our team includes members of the Law Society’s specialist panel of clinical negligence solicitors and the Action against Medical Accidents (Avma) solicitors panel, and these accreditations recognise the quality of the legal services we provide.